Republic of the Philippines

Department of Education
REGION III - CENTRAL LUZON
SCHOOLS DIVISION OFFICE OF NUEVA ECIJA
STO. DOMINGO ANNEX
Malasin, Sto. Domingo, Nueva Ecija

_______________________
Petsa
______________________
______________________
______________________

Mahal na Magulang;

Magandang araw po!

Naniniwala po kaming ang ikapapanuto ng ating mag-aaral ay nasa pagtutulungan ng
mga magulang at mga guro. Dahil po rito ay nais naming kayong kausapin tungkol sa inyong
anak na si _______________________________________ na nasa baytang _______ at pangkat
_________________. Hinihiling po namin na kayo ay makikipagkita sa amin sa ika-________ ng
umaga/hapon, ika-_____ ng ________________________, _______.

Ang inyong anak ay;

( ) Lumiban sa klase sa loob ng ______ araw.
( ) Lumabag sa patakaran ng paaralan.
( ) Nasangkot sa _____________________________ ( suliranin ).
( ) Ibang kadahilanan.
( ) May pulong o FPTCA Meeting.

Inaasahan po naming hindi ninyo kami bibiguin. Sumainyo Po Nawa ang Pagpapala ng
Poong Maykapal.

Sumasainyo,

_______________________
Gurong Tagapayo

_______________________ ___________________________________
Punong Guro School Guidance Coordinator

GUPITIN AT IBALIK ANG SAGOT

_______________________
Petsa

G./Gng./Bb. ________________________
________________________

Tinanggap ko po ang inyong liham ukol sa aking:

_____ anak _____ pamangkin _____ kamag- anak
_____ pinsan _____ alaga _____ apo
At
_____ dadalo po ako bukas
_____ darating po ako ngayon
_____ darating po ako sa umaga/hapon
_____ hindi po ako makakadalo o makakarating: sa dahilang __________________________________

Sumasainyo,

_______________________
(Magulang)
 Republic of the Philippines
Department of Education
REGION III - CENTRAL LUZON
SCHOOLS DIVISION OFFICE OF NUEVA ECIJA
STO. DOMINGO ANNEX
Malasin, Sto. Domingo, Nueva Ecija

ANECDOTAL RECORDS

SCHOOL: ________________________________________________

Name:
_______________________________________________________________________________________________
Last Name First Name Middle Name
Grade & Section: ___________________________ LRN: ____________________ Sex: _____________
Address: ______________________________________________________________________________________
Date of Birth: ________________________ Place of Birth: _______________________________________
Parents: (Father) ______________________________ (Mother) _____________________________________
Father’s Date of Birth: ________________________ Mother’s Date of Birth: ______________________
Occupation: (Father) _____________ (Mother) _____________ Religion __________ Dialect____________
Educational Attainment (Father) __________________________ (Mother) __________________________

Description/Important Notes:
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________

Prepared by:

_____________________________
Teacher/Adviser

Noted:

_____________________________
School Head
 Republic of the Philippines
Department of Education
REGION III - CENTRAL LUZON
SCHOOLS DIVISION OFFICE OF NUEVA ECIJA
STO. DOMINGO ANNEX
Malasin, Sto. Domingo, Nueva Ecija

GUIDANCE SERVICES

LEARNER’S INFORMATION SHEET

_______________________________________________________ _________________ __________________

Last Name First Name Middle Name LRN Grade - Section
Home Address: ______________________________________________________________________________
House No. Street/Barangay Town Province
Birthdate: ______________________________________________________ Sex: ___________________
Month Day Year
Birthplace: ____________________________________________________________________________________
Street Barangay Town Province
Guardian: ____________________________________________________________________________________
Address: ______________________________________________________________________________________
Parents: (Father) __________________________________ (Mother) __________________________________
Parents Occupation: Father ________________________ other source of income: ___________________
Mother _______________________ other source of income: ___________________
No. of Brothers: __________________________ No. of Sister: _____________________________
Special Talent/Skills: _________________________________________________________________________
Hobbies: ______________________________________ Ambition: ________________________________
Club and Extra Curricular Engaged in (outside the school) _____________________________________
_______________________________________________________________________________________________

ELEMENTARY EDUCATION
School Year Grade Level Name of School Gen. Average Honors/Awards Received
Kinder
Grade I
Grade II
Grade III
Grade IV
Grade V
Grade VI

Prepared by:

___________________________
Teacher/Adviser

Submitted by:

___________________________
School Guidance Coordinator

Noted:

___________________________
School Head
 Republic of the Philippines
Department of Education
REGION III - CENTRAL LUZON
SCHOOLS DIVISION OFFICE OF NUEVA ECIJA
STO. DOMINGO ANNEX
Malasin, Sto. Domingo, Nueva Ecija

REFERRAL SLIP

Name of Student: __________________________________________ Age: _________ Sex:

____________
Grade and Section: ______________________________ Adviser: __________________________________

Reason for Referral:

_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________

_________________________________ __________________________
Teacher Date

Action taken:

_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________

Record Attached:
ANECDOTAL RECORDS

Referred to:

______________________________________
School Guidance Coordinator
 Republic of the Philippines
Department of Education
REGION III - CENTRAL LUZON
SCHOOLS DIVISION OFFICE OF NUEVA ECIJA
STO. DOMINGO ANNEX
Malasin, Sto. Domingo, Nueva Ecija

PATAKARAN AT TUNTUNIN SA PAARALAN

1. Igalang mo ang mga guro, mga bisita at lahat ng mga manunungkulan sa paaralan. Alamin
ang kanilang mga pangalan at tawagin sila sa kanilang mga pangalan. Lagi silang tawagin ng
may paggalang tulad ng Mr./G., Mrs./Gng., Miss/Bb o maaring Madam o Sir.
2. Batiin ang mga guro at lahat ng mga nanunungkulan sa paaralan ng Magandang
Umaga/Good Morning, Magandang Hapon/Good Afternoon o kung kalian kinakailangan.
3. Humingi ng pahintulot sa gurong nagtuturo bago pumasok sa silid paaralan. Alisin ang
sombrero bago pumasok sa silid paaralan o saan mang gusali ng paaralan.
4. Magdala ng liham na may lagda ng magulang ang sinumang mag-aaral na nahuli o lumiban
sa klase.
5. Magsuot ng uniporme araw-araw.
6. Ikabit ang ID na naglalaman ng larawan ng may-ari nito sa tamang lugar na nakikita bago
pumasok sa paaralan.
7. Iwasan ang paglilibot at paggawa ng ingay sa “korido“ at sa lugar na malapit sa silid- aralan.
8. Pangalagaan ang lahat ng pag-aari ng paaralan. Huwag susulatan o uukitin ng kahit na ano
ang mga upuan, dingding o pirasa.
9. Magdala ng sariling aklat, lapis, ballpen, papel at iba pang kailangan. Huwag maging pabigat
sa iba.
10.Dumalo sa pagtataas ng watawat sa araw-araw. Tumayo ng matuwid kapag inaawit ang
pambansang awit. Iwasan ang di- kinakailangang kilos, pag-uusap o tawanan.
11.Makinig sa taga-pagsalita at pumapalakpak kung kinakailangan.
12.Iwasan ang pagkakalat sa paligid ng paaralan upang mapanatili ang kalinisan nito.
13.Tandaan na lagi kang maging tapat sa iyong paaralan.

Nauunawaan ko ang lahat ng tuntunin at patakaran ng paaralang ito, at ako ay nangangakong

susundin ito sa lahat ng oras.

___________________________ ___________________________
Lagda ng Magulang Lagda ng Mag-aaral

___________________________ ___________________________
Punong-Guro Tagapayo